NPIMap

Organization Active NPI

Bradley Bibb, MD PLLC

Doing business as Access Medical Clinic Weiner

  • Rural Health Clinic/Center
  • Weiner, AR
National Provider Identifier
1770938870
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BRADLEY BIBB, MD PLLC
Doing business as
Access Medical Clinic Weiner
Practice address
106 N Van Buren St
Weiner, AR 72479-9289
Phone
(870) 605-0014
Fax
(870) 994-7488
NPI assigned
Apr 27, 2016
Last updated
Feb 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bradley Ray BibbNPI 1700824307
Title
Ceo
Phone
(870) 994-7301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

106 N Van Buren St
Weiner, AR 72479-9289

Mailing address

101 W Main St
Hardy, AR 72542-9566

Other practice location 1

106 North Van Buren Street
Weiner, AR 72479
Phone (870) 994-7301

Other names 1

  • Access Medical Clinic Weiner Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100628000488 AR Part B Supplier - Clinic/Group Practice 4789715285 Receives reassigned benefits from 95 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ash Flat, AR; Black Rock, AR; Bono, AR; Dardanelle, AR; Hardy, AR; Marked Tree, AR; Salem, AR; Texarkana, AR

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1770938870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MAIN ST",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725429566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N VAN BUREN ST",
            "city": "WEINER",
            "state": "AR",
            "postal_code": "724799289",
            "telephone_number": "870-605-0014",
            "fax_number": "870-994-7488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 North Van Buren Street",
            "address_purpose": "LOCATION",
            "city": "Weiner",
            "state": "AR",
            "postal_code": "72479",
            "country_code": "US",
            "telephone_number": "870-994-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRADLEY BIBB, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "BIBB",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-994-7301"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Medical Clinic Weiner",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Medical Clinic Weiner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weiner, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.